Monthly Archives: March 2011

Tai Chi Eases Depression in Elderly

2011-03-21

The ancient Chinese practice of tai chi appears to relieve symptoms of depression in older people, a new study shows.

The findings, published this month in The American Journal of Geriatric Psychiatry, are the latest to suggest that the slow movement, breathing and meditation of tai chi results in meaningful benefits to patients with chronic health problems. Other recent studies have shown that practicing tai chi may provide benefits for patients with arthritis and fibromyalgia. But the newest research is important because depression is notoriously difficult to treat in older people, many of whom are already coping with other health problems and are less likely to respond to drug treatment.

Researchers from the University of California, Los Angeles, studied 112 older adults in whom major depression had been diagnosed, including many who had been struggling with the illness for years. Their average age was about 70. Everyone was first treated with Lexapro, and 73 exhibited a partial improvement but still scored high on depression scales. The rest of the patients dropped out of the study, including just one patient who had a full remission after drug treatment.

The remaining depressed patients were randomly assigned to either a 10-week course of tai chi or a health education class, which included 10 minutes of simple stretching exercises. Both courses were given for two hours once a week.

After 10 weeks of tai chi, 94 percent of depressed older adults showed marked improvement on depression scales, compared with 77 percent in the health education group. And 65 percent of the people in the tai chi group experienced remission, compared with 51 percent in the education group.

The tai chi group also showed marked improvement in measures of physical function, cognitive tests and blood tests measuring levels of inflammation.

“Altogether the effects were pretty dramatic,’’ said Dr. Helen Lavretsky, lead author and professor of psychiatry at U.C.L.A. “If a psychiatrist were to add exercise like tai chi, which is very nondemanding and easy to access, that would be a very beneficial thing instead of adding another drug.”

Dr. Lavretsky said one reason both study groups showed improvement was that all the patients probably benefited from spending time with other people, whether it was in the practice of tai chi or the group education class. “I’m sure the social aspect contributed to the improvement in both groups,’’ she said. “In the control group we see improvement, and that was purely because of the social interaction and bonding that occurred.”

But the marked improvement in the tai chi group suggests an additional benefit from tai chi. Research has shown tai chi can improve physical function and quality of life, relieve stress and anxiety and lead to improved sleep quality, the study authors noted.

The study used a form of tai chi called T’ai Chi Chih that uses 20 simple exercises that are nonstrenuous and easy enough to be performed by older adults.

Dr. Lavretsky said the findings are exciting because depression is so difficult to treat in older people, two-thirds of whom don’t respond to initial drug therapy. Often when a patient doesn’t respond to the first drug, an additional drug is given, but that’s not always practical for patients who are already taking 10 or 15 drugs for other health problems. A study this month found that more than 60 percent of patients over 65 experience moderate or major side effects the first time they are prescribed an antidepressant.

“This is very easily translatable into community care,’’ she said. “As their health improves, they may be able to reduce the other drugs they are taking for pain or other problems.”

Q: I’m afraid I’m a loud snorer. Is there anything I can do to prevent this from happening when I spend the night with my new man?

You mean aside from lying awake all night? First, don’t drink alcohol. It can make snoring worse by relaxing your throat’s muscles. When you breathe in and out, those relaxed muscles vibrate, and you snore.

Also, congested nasal passages contribute to snoring, so you might want to bring along a box of nasal strips and pop one on before climbing in bed (just say you have allergies). They may not be pretty, but they open up your nasal passages from the outside in, letting air flow more easily.

If these moves don’t help you get your snoring under control, you may have obstructive sleep apnea – a serious respiratory condition – and should make an appointment to discuss this problem with your doctor.

But, to be honest, you shouldn’t be embarrassed about this or any other bodily function. If this is going to be a long-term relationship, sooner or later he’s going to hear you snore. And if he dumps you because of that, what a jerk!

First period tied to girl's weight…..

2011-03-18

Overweight or obese girls get their first period months earlier than their normal-weight peers, according to a Danish study.

It’s nothing new that girls are getting younger and younger when they have their first period, but experts worry that the current obesity epidemic could be fueling that trend.

Early-onset menstruation is linked to later health problems such as breast cancer, said Sarah Keim, a researcher at The Ohio State University College of Medicine in Columbus, who wasn’t involved in the new study.

Girls who get their period early in life are also more likely to have sex sooner than their peers, Keim added, which increases the risk of teen pregnancy and sexually transmitted diseases.

About 17 percent of American kids and teens are obese, according to the Centers for Disease Control and Prevention.

For the study, researchers used information on body mass index (BMI) — a measure of weight in relation to height — and age at first period from about 3,200 Danish girls born between 1984 and 1987.

The girls started their period just after they had turned 13, on average, which is about half a year later than in the U.S. Keim said part of the reason for this difference may be that African-Americans tend to start their periods before white girls.

On average, a girl got her period about 25 days earlier for every point her BMI increased. For a female of about average height and weight, a one-point change in BMI is equivalent to about six pounds.

Overweight and obese girls, for example, got their period three to five months before normal-weight girls, said Anshu Shrestha, a graduate student at UCLA School of Public Health, who worked on the study.

There has been past research showing a link between BMI and when girls start menstruating. However, since this study was done more recently, it shows that the link is holding up in today’s generation, Keim said.

The researchers also found that a girl’s mother’s weight was related to when her daughter started menstruating, but less so than earlier work had hinted.

For every point her mother’s BMI when pregnant went up, the girl’s period came about a week earlier, according to the new study, which was published in the journal Fertility and Sterility.

Keim said the Danish findings reinforce the importance of keeping a healthy weight.

“It’s important for your entire life, starting from very early on,” she told Reuters Health. “And it can even affect your children’s health.”

Hormones may be better than soy for hot flashes

2011-03-17

Hormone replacement therapy may work slightly better than soy at reducing menopausal hot flashes, a new study says.

Women who took such hormones had fewer hot flashes, on average, than women who took soy – and both had fewer than those who took a placebo, or “dummy pill.”

“The bottom line for someone who is very disturbed by hot flashes, the best treatment is hormones, and the next tier would be soy,” said Dr. Gloria Bachmann, professor of obstetrics and gynecology at the Robert Wood Johnson Medical School in New Jersey.

However, a 2002 landmark study by the National Institutes of Health (NIH) found that such treatments can increase the risk of breast cancer, heart disease and stroke. That means that if women do take hormones, Bachmann told Reuters Health, it should be the lowest dose and for the shortest possible period of time.

And not every woman needs treatment, notes Bachmann, who was not involved in the study. Women with severe or frequent hot flashes or whose hot flashes keep them up at night, should consider treatment, she said.

Women typically suffer between 30 and 150 hot flashes a month, said Dr. Rafael Bolanos-Diaz, professor of health economics at San Marcos University in Lima, Peru, who co-authored the study.

Women who took hormones had an average of 24 fewer hot flashes per month, while those who took soy had 12 per month fewer. The study did not look at whether eating soy in food has the same effect on hot flashes as supplements, Bolanos-Diaz said.

The researchers looked at 19 studies on how a treatment, either hormones or soy, compared to a placebo. They compared the average number of hot flashes in 760 women who had treatment with 770 who did not.

The study was published in Menopause: The Journal of the North American Menopause Society.

Soy hasn’t been studied as much as hormone replacement to treat hot flashes, and doctors don’t know exactly how it works. It’s thought to have similar effects to estrogen on the brain, bones, and blood vessels, Bolanos-Diaz told Reuters Health by email.

Soy supplements also have side effects: Nausea, bloating, and constipation, according to the NIH. A month’s supply costs about $12, while a month of hormone tablets runs between $40 and $60.

“For some women, hormone therapy is the best option, for some soy is best, and for some, it’s just watchful waiting until the hot flashes subside,” Bachmann said.

SOURCE: bit.ly/hBua85 Menopause: The Journal of The North American Menopause Society

Breast cancer may not change lifespan for older women

2011-03-15

Older women who are diagnosed with early-stage breast cancer can expect to live just as long as peers without breast cancer, according to a new study.

That’s “a very encouraging message,” said Dr. Elena Elkin, a breast cancer researcher at Memorial Sloan-Kettering Cancer Center who was not involved with the study. “More of the breast cancers we find are very small and diagnosed at an early stage. For older women especially these cancers generally have a favorable diagnosis,” she told Reuters Health.

More than 200,000 women are diagnosed with breast cancer each year in the U.S., and a woman’s risk of getting the disease increases as she gets older.

There is ongoing debate in the medical community, however, over whether routine screening for certain cancers will actually extend lives, particularly in older people whose life expectancy is likely to be influenced by other health issues, such as heart disease.

In the current study, researchers compared the life expectancy and causes of death in women age 67 and older who were diagnosed with breast cancer and in a similar group of women without breast cancer.

By consulting a register of cancer diagnoses in Medicare patients, the authors, led by Dr. Mara Schonberg of the Beth Israel Deaconess Medical Center in Brookline, Massachusetts, were able to identify almost 65,000 older women who were diagnosed with breast cancer of any stage between 1992 and 2003. For comparison, they collected information for a group of about 170,000 women of similar age, also on Medicare, who were not diagnosed with breast cancer.

The researchers tracked women in both groups through 2006 – close to 8 years of follow-up on average – to determine how many of them died, and from what cause.

Women diagnosed with ductal carcinoma in situ (DCIS) – the earliest stage of breast cancer – and stage I cancer were just as likely to survive through the end of the study period as women who were never diagnosed with cancer.

Women under 80 who were diagnosed with DCIS were actually slightly more likely to survive for at least 5 years than women who were not diagnosed with breast cancer. That could be because of the “healthy user effect,” the authors say – women who are diagnosed with breast cancer are more likely to have been screened for cancer than women who aren’t diagnosed, and may also be more health-conscious in other ways.

Women with stage I breast cancer and those over 80 with DCIS had the same rate of survival over the course of the study as women without breast cancer.

In women under 80 years old, 89 percent survived 5 years after a diagnosis of DCIS and 87 percent after being diagnosed with stage I cancer. In women age 80 and older, 70 percent were still alive 5 years after being diagnosed with DCIS, compared to 66 percent who were diagnosed with stage I breast cancer.

Between 6 and 18 percent of women with early stage cancer that died within 5 years died from breast cancer. Heart disease was the most common cause of death for women with early stage breast cancer.

Survival chances were higher in women with early-stage breast cancer when they had a mastectomy or breast-conserving surgery and radiation together, rather than when they just had breast-conserving surgery or had no surgery at all.

When older women were diagnosed with stage II or higher breast cancer, they did not survive as long as the non-cancer group. A stage II diagnosis, for example, meant women were 1.5 times less likely to survive the study period than women without breast cancer, and a stage III diagnosis meant they were three times less likely to survive.

The findings, the authors say, suggest that doctors should be talking with older women about the risks and benefits of being screened for breast cancer. Screening might pick up an early stage cancer that is advancing – in which case treatment could prevent the cancer from becoming worse.

In some cases, however, screening might pick up cancers that would not end up cutting a woman’s life short, especially if she was at risk of dying from another condition, such as heart disease. In that sense, a woman is at risk of being treated with invasive procedures unnecessarily since they would not extend her expected lifespan.

“I suspect that a lot of these cancers are cancers that never would have affected someone’s life expectancy” had they not been caught, Schonberg told Reuters Health. However, she said, it’s very hard to know which cancers are going to progress and which are not likely to cause a woman’s death.

“This is the fundamental problem in screening for cancer in general,” Elkin added. She said that each woman’s decision about whether or not to get screened should depend on how much she would benefit from doctors catching an early-stage cancer. Every older woman “should not just get a mammogram routinely, but have a discussion with her doctor,” she said.

The main message is that “screening can be effective even in older women,” Elkin said. “What’s important is not necessarily a woman’s age but her general health and her life expectancy … and that’s true for any age.”